Hopkins sets up hot line to deal with cancer pain

December 05, 1992|By Jonathan Bor | Jonathan Bor,Staff Writer

The Johns Hopkins Hospital has established the nation's firs telephone hot line devoted solely to questions about cancer pain -- a problem that research shows has been poorly treated in the majority of cases.

"Our goal is not to prescribe medication for the patient, and it's not to tell patients exactly what they must have," said Dr. Stuart Grossman, a Hopkins oncologist who is directing the hot line.

"It's to tell them about their options and encourage them to talk to their physician."

The hot line, operating from 9:30 a.m. to 4:30 p.m. Monday through Friday, will be staffed by "information specialists" who in turn will consult with oncologists and other physicians to answer questions about pain management. The telephone number is 1-800-422-6237.

Although the hot line may some day find a regional audience, it is being targeted to patients throughout Maryland whether or not they get their health care at Hopkins. It is also a service for physicians, nurses, pharmacists, family members and friends concerned about a patient's well-being.

Dr. Grossman said he wants to spread the word that cancer pain can be controlled in more than 90 percent of cases, yet most patients in pain do not get adequate relief because of outmoded attitudes held by both doctors and patients.

He said medical students receive little training in pain relief and many doctors are concerned more with treating the cancer than relieving the pain.

Patients are sometimes afraid to complain about their pain, he said, because they fear it signals a worsening cancer.

Also, he said doctors and patients both harbor an unwarranted fear that narcotics, which are often the best weapon against pain, will lead to addiction.

"Addiction shouldn't be the first, second, third or fourth concern," Dr. Grossman said. "Addiction in cancer patients who are taking medication for pain relief is extraordinarily rare."

In some cases, a patient can be taken off narcotics once treatments such as radiation succeed in shrinking the tumor causing the pain. In such cases, the patient may never become chemically dependent.

Some patients who have been on the drugs for long periods can be weaned gradually to prevent withdrawal symptoms. And when pain cannot be stopped at the source, dependency may be an acceptable alternative to intractable pain.

Johns Hopkins is one of several institutions in the country that have received funding from the National Cancer Institute to disseminate information about cancer pain to patients and health care workers.

The effort stems from a growing recognition that patients are going untreated. Also, physicians concerned with the problem have become more adept at using medications that have been on the shelf.

"We have all the tools we need to do a good job," Dr. Grossman said. "It's not like we need all kinds of fancy new treatments and technologies to do a good job."